Distal radius malunion increases risk of persistent disability 2 years after fracture: a prospective cohort study.
Clin Orthop Relat Res
; 471(5): 1691-7, 2013 May.
Article
in En
| MEDLINE
| ID: mdl-23361928
ABSTRACT
BACKGROUND:
Studies concerning the relationship between distal radius fracture malunion and a persistent arm-related disability have produced conflicting results. QUESTIONS/PURPOSES:
We investigated (1) how arm-related disability changes during the first 2 years after a fracture and (2) whether fracture malunion causes persistent disability.METHODS:
One hundred twenty-three patients with distal radius fractures, treated with closed reduction and casts or external or percutaneous pin fixations, completed the DASH questionnaire at baseline, 3 months, 6 months, 1 year, and 2 years after fracture. Radiographic measurements were made at 1 year. Using a definition of malunion as ulnar variance of 1 mm or more and dorsal tilt greater than 10°, the patients were classified into three groups no malunion (n = 35), malunion involving either ulnar variance or dorsal tilt (n = 65), and malunion involving ulnar variance and dorsal tilt (n = 23). The changes in the DASH scores with time (baseline to 2 years), in relation to malunion, were analyzed using generalized estimating equations adjusted for age, sex, fracture type (extraarticular or intraarticular), and treatment method.RESULTS:
The mean change in DASH scores from baseline to 2 years was worse for patients with malunions involving ulnar variance and dorsal tilt than for patients with no malunions (mean difference, 13; 95% CI, 1.4-25) and for patients with malunions involving either ulnar variance or dorsal tilt (mean difference, 13; 95% CI, 2.2-24).CONCLUSION:
After distal radius fracture, arm-related disabilities are more likely to persist at least 2 years in patients with fractures that healed with shortening and dorsal angulation than in patients with only shortening or dorsal angulation or without malunion.
Full text:
1
Database:
MEDLINE
Main subject:
Radius Fractures
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Surveys and Questionnaires
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Fracture Healing
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Fractures, Malunited
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Disability Evaluation
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Fracture Fixation
Type of study:
Clinical_trials
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Diagnostic_studies
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Etiology_studies
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Observational_studies
/
Risk_factors_studies
Limits:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
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Male
/
Middle aged
Country/Region as subject:
Europa
Language:
En
Journal:
Clin Orthop Relat Res
Year:
2013
Type:
Article
Affiliation country:
Sweden